Abstract
In three cases of pulmonary tuberculosis associated with the adult respiratory distress syndrome the clinical features, which were similar to those of patients with miliary tuberculosis and adult respiratory distress syndrome, included a history of cough, fever, and dyspnoea on effort, and the physical signs of fever, tachypnoea, pulmonary adventitious sounds, tachycardia, and hepatomegaly. In these cases the radiological features, though suggestive of diffuse pulmonary oedema, were more prominent on the side in which the cavitatory lesion appeared. The diagnosis of tuberculosis was made easily from direct examination of sputum. Despite early ventilatory support and antituberculous therapy, two of the three patients died. Postmortem examination of the lungs in these cases showed evidence of acute alveolar damage (loss of type 1 pneumocytes and the presence of hyaline membranes within alveolar ducts) and of chronic alveolar damage (interstitial and alveolar fibrosis).
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- Agarwal M. K., Muthuswamy P. P., Banner A. S., Shah R. S., Addington W. W. Respiratory failure in pulmonary tuberculosis. Chest. 1977 Nov;72(5):605–609. doi: 10.1378/chest.72.5.605. [DOI] [PubMed] [Google Scholar]
- Ashbaugh D. G., Bigelow D. B., Petty T. L., Levine B. E. Acute respiratory distress in adults. Lancet. 1967 Aug 12;2(7511):319–323. doi: 10.1016/s0140-6736(67)90168-7. [DOI] [PubMed] [Google Scholar]
- Hammerschmidt D. E., White J. G., Craddock P. R., Jacob H. S. Corticosteroids inhibit complement-induced granulocyte aggregation. A possible mechanism for their efficacy in shock states. J Clin Invest. 1979 Apr;63(4):798–803. doi: 10.1172/JCI109365. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Horne N. W. A critical evaluation of corticosteroids in tuberculosis. Bibl Tuberc. 1966;22:1–54. [PubMed] [Google Scholar]
- Huseby J. S., Hudson L. D. Miliary tuberculosis and adult respiratory distress syndrome. Ann Intern Med. 1976 Nov;85(5):609–611. doi: 10.7326/0003-4819-85-5-609. [DOI] [PubMed] [Google Scholar]
- JOHNSON J. R., TAYLOR B. C., MORRISSEY J. F., JENNE J. W., MCDONALD F. M. CORTICOSTEROIDS IN PULMONARY TUBERCULOSIS. I. OVER-ALL RESULTS IN MADISON-MINNEAPOLIS VETERANS ADMINISTRATION HOSPITALS STEROID STUDY. Am Rev Respir Dis. 1965 Sep;92:376–391. doi: 10.1164/arrd.1965.92.3.376. [DOI] [PubMed] [Google Scholar]
- MARCUS H., YOO O. H., AKYOL T., WILLIAMS M. H., Jr A randomized study of the effects of corticosteroid therapy on healing of pulmonary tuberculosis as judged by clinical, roentgenographic, and physiologic measurements. Am Rev Respir Dis. 1963 Jul;88:55–64. doi: 10.1164/arrd.1963.88.1.55. [DOI] [PubMed] [Google Scholar]
- Munt P. W. Miliary tuberculosis in the chemotherapy era: with a clinical review in 69 American adults. Medicine (Baltimore) 1972 Mar;51(2):139–155. doi: 10.1097/00005792-197203000-00004. [DOI] [PubMed] [Google Scholar]
- Murray H. W., Tuazon C. U., Kirmani N., Sheagren J. N. The adult respiratory distress syndrome associated with miliary tuberculosis. Chest. 1978 Jan;73(1):37–43. doi: 10.1378/chest.73.1.37. [DOI] [PubMed] [Google Scholar]
- Raimondi A. C., Olmedo G., Roncoroni A. J. Acute miliary tuberculosis presenting as acute respiratory failure. Intensive Care Med. 1978 Nov;4(4):207–209. doi: 10.1007/BF01902549. [DOI] [PubMed] [Google Scholar]
- Sahn S. A., Neff T. A. Miliary tuberculosis. Am J Med. 1974 Apr;56(4):494–505. doi: 10.1016/0002-9343(74)90482-3. [DOI] [PubMed] [Google Scholar]
- Sahn S. A., Skeff K. M. Tuberculous pneumonia with the syndrome of inappropriate secretion of antidiuretic hormone: cause of the adult respiratory distress syndrome. Chest. 1977 Nov;72(5):678–680. doi: 10.1378/chest.72.5.678. [DOI] [PubMed] [Google Scholar]
- Sladen A. Methylprednisolone. Pharmacologic doses in shock lung syndrome. J Thorac Cardiovasc Surg. 1976 May;71(5):800–806. [PubMed] [Google Scholar]
- So S. Y., Yu D. The adult respiratory distress syndrome associated with miliary tuberculosis. Tubercle. 1981 Mar;62(1):49–53. doi: 10.1016/0041-3879(81)90036-2. [DOI] [PubMed] [Google Scholar]
- Stoupel E., de Backer M., Kahn R. J. Détresse respiratoire de l'adulte et tuberculose miliaire. Anesth Analg (Paris) 1980;37(7-8):429–432. [PubMed] [Google Scholar]
- Voisin C., Wattel F., Tonnel A. B., Scherpereel P., Chopin C., Vallet P. M., Loison G. La tuberculose, facteur étiologique de détresses respiratoires aiguës. Rev Tuberc Pneumol (Paris) 1971 Sep-Oct;35(6):631–638. [PubMed] [Google Scholar]
- Weisman I. M., Rinaldo J. E., Rogers R. M. Current concepts: positive end-expiratory pressure in adult respiratory failure. N Engl J Med. 1982 Nov 25;307(22):1381–1384. doi: 10.1056/NEJM198211253072205. [DOI] [PubMed] [Google Scholar]
- Zimmerman H. M., Wertheimer D. E., Rosner F. Miliary tuberculosis and adult respiratory distress syndrome. N Y State J Med. 1981 Apr;81(5):787–789. [PubMed] [Google Scholar]



